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Wearing a cycle helmet may increase risk of injury, says new research

Paper presented at National Road Safety Conference in Telford

New research suggests that wearing a helmet may put cyclists more at risk of being injured in a road traffic collision.

The findings are set out in a paper entitled Effects of bicycle helmet wearing on accident and injury rates presented at this week’s National Road Safety Conference in Telford.

Former Cycling UK councillor Colin Clarke and author and journalist Chris Gillham analysed overall changes in accident risk with increased helmet wearing.

They looked at data from Australia and New Zealand, both of which have nationwide mandatory helmet laws, the US and Canada, where compulsion is widespread particularly for children but laws vary in local jurisdictions, and the UK, where there is no legal requirement to wear one.

Summarising their findings, they said: “Bicycle helmet wearing globally has increased over the past 30 years via promotion and in some cases legislation.

“Various reports have assessed the changes in wearing rates, accidents, injuries and cycling activity levels.

“A limited number of reports have analysed overall changes in accident risk per kilometres cycled, per hours cycled or in relationship to cycling levels via survey information.

“A significant number of findings suggest a higher accident/injury rate may result from helmet usage and there is strong evidence that helmeted cyclists suffer a higher rate of upper body limb injuries than non-wearers, suggesting a higher rate of falls than non-wearers.”

Besides highlighting an increased casualty rate among cyclists wearing helmets, they also noted that according to census data, the compulsory helmet laws introduced in Australia and New Zealand in the 1990s had led to a reduction in cycling.

For example, they highlighted that “Children’s cycling in New Zealand reduced from 23 million hours to 13.6 million hours in less than a 10 year period and currently is about 4 to 5 million hours per year.”

That ties in with one argument often put forward by opponents of mandatory helmet laws, namely that discouraging people from cycling through such legislation ultimately has an adverse effect on public health generally.

To put that another way,  the perceived reduction in casualties of cyclists brought about by making helmets compulsory is outweighed by the fact that such laws deter people from cycling, and therefore do not aid efforts to tackle more widespread issues such as obesity which exercise can help address.

In conclusion, Clarke and Gillham said: “The possible reasons for increased risk of injury per cyclist, particularly upper extremities, appear to be due to increased falls.

“It appears helmet use increases the accident rate by more than 40 per cent.

“This should be the subject of further research to determine why overall accident and injury rates outweigh head injury benefits provided by helmets.”

Simon joined road.cc as news editor in 2009 and is now the site’s community editor, acting as a link between the team producing the content and our readers. A law and languages graduate, published translator and former retail analyst, he has reported on issues as diverse as cycling-related court cases, anti-doping investigations, the latest developments in the bike industry and the sport’s biggest races. Now back in London full-time after 15 years living in Oxford and Cambridge, he loves cycling along the Thames but misses having his former riding buddy, Elodie the miniature schnauzer, in the basket in front of him.

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93 comments

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Colin Clarke | 4 years ago
2 likes
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efail | 4 years ago
4 likes

Am I in the right place to discuss battery hens? I've had a drink, (I'm worried about that comma) before you start.

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hawkinspeter replied to efail | 4 years ago
4 likes
efail wrote:

Am I in the right place to discuss battery hens? I've had a drink, (I'm worried about that comma) before you start.

Well, they've got positives and negatives.

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Argus Tuft | 4 years ago
3 likes

Is it allowable to believe my helmet may have saved me from serious injury without supporting mandatory helmet laws?

Kitten-I strongly disagree with the opinion expressed in your last post,but I'll die in a ditch defending your right to promote it.

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FluffyKittenofT... replied to Argus Tuft | 4 years ago
0 likes

Argus Tuft wrote:

Kitten-I strongly disagree with the opinion expressed in your last post,but I'll die in a ditch defending your right to promote it.

 

Also - not sure what the point here is.  Is that the same ditch as Boris Johnson was going to be found dead in?  I guess it's still available as he didn't follow through on the promise.

 

Anyway, I don't get the relevance - I wasn't aware anyone was proposing censorship or a Stalinist purge on the basis of beliefs about helmets, either way.

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Argus Tuft replied to FluffyKittenofTindalos | 4 years ago
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FluffyKittenofTindalos wrote:

Argus Tuft wrote:

Kitten-I strongly disagree with the opinion expressed in your last post,but I'll die in a ditch defending your right to promote it.

 

Also - not sure what the point here is.  Is that the same ditch as Boris Johnson was going to be found dead in?  I guess it's still available as he didn't follow through on the promise.

 

Anyway, I don't get the relevance - I wasn't aware anyone was proposing censorship or a Stalinist purge on the basis of beliefs about helmets, either way.

Not so much censorship-more bullying and belittlement-And brush up on your Voltaire,Sonny Jim!

 

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John Pitcock | 4 years ago
1 like

When I go shopping on my bike, which usually involves going into several shops in a high-street,  I rarely wear a helmet becasue it is an encumberance. I live at the bottom of a steep residential road - when I am returning home wearing a helmet I go faster and take more risks: when I'm not wearing one I am aware of the extra consequences of a fall and go more carefully.

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Hirsute replied to John Pitcock | 4 years ago
2 likes

John Pitcock wrote:

When I go shopping on my bike, which usually involves going into several shops in a high-street,  I rarely wear a helmet becasue it is an encumberance.

That's probably a situation where a helmet would be of net benefit due to low speeds, kerbs and other street furniture.

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CyclingInBeastMode replied to John Pitcock | 4 years ago
3 likes

John Pitcock wrote:

When I go shopping on my bike, which usually involves going into several shops in a high-street,  I rarely wear a helmet becasue it is an encumberance. I live at the bottom of a steep residential road - when I am returning home wearing a helmet I go faster and take more risks: when I'm not wearing one I am aware of the extra consequences of a fall and go more carefully.

This precisely describes the effects of risk compensation, we see this not just in cycling but in many sports and activities including the work environment/building sites, when RIDDOR was introduced the stats I looked at found that accident rates didn't go down despite the massive increase reporting procedures + hard hat and hi-vis wearing. As with cycling the biggest influence in terms of H&S are down to modifying behaviour of people through work practises, changing environment and enforcing the rules + retraining/refresher and effective supervision/management to ensure people are abiding by the rules in place.

Things like wearing a hard hat on a site is mostly because other people are acting carelessly/recklessly, people wearing hard hats take greater risks on site because they feel more protected, that crane operator wearing a hard hat actually influences how they themselves feel toward risk despite them not actually been at risk themselves so there is an increased chance of incident.This is replicated by the actions of people in cars and their safety cell/protections and backed up in tests on children and adults when studying the effects of risk homeostasis.

The most noticeable effects of helmets in cycling is within competitive racing, despite all the safety changes particularly at elite level where on course protocols have changed, more marshals/warnings of hazards, more barriers and the added better brakes/tyres, cyclists still crash more often, get injured more often and die more often (compared to pre helmet rule era) despite 100% helmet wearing.

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Argus Tuft replied to CyclingInBeastMode | 4 years ago
0 likes

CyclingInBeastMode wrote:

John Pitcock wrote:

When I go shopping on my bike, which usually involves going into several shops in a high-street,  I rarely wear a helmet becasue it is an encumberance. I live at the bottom of a steep residential road - when I am returning home wearing a helmet I go faster and take more risks: when I'm not wearing one I am aware of the extra consequences of a fall and go more carefully.

This precisely describes the effects of risk compensation, we see this not just in cycling but in many sports and activities including the work environment/building sites, when RIDDOR was introduced the stats I looked at found that accident rates didn't go down despite the massive increase reporting procedures + hard hat and hi-vis wearing. As with cycling the biggest influence in terms of H&S are down to modifying behaviour of people through work practises, changing environment and enforcing the rules + retraining/refresher and effective supervision/management to ensure people are abiding by the rules in place.

Things like wearing a hard hat on a site is mostly because other people are acting carelessly/recklessly, people wearing hard hats take greater risks on site because they feel more protected, that crane operator wearing a hard hat actually influences how they themselves feel toward risk despite them not actually been at risk themselves so there is an increased chance of incident.This is replicated by the actions of people in cars and their safety cell/protections and backed up in tests on children and adults when studying the effects of risk homeostasis.

 

The most noticeable effects of helmets in cycling is within competitive racing, despite all the safety changes particularly at elite level where on course protocols have changed, more marshals/warnings of hazards, more barriers and the added better brakes/tyres, cyclists still crash more often, get injured more often and die more often (compared to pre helmet rule era)despite 100% helmet wearing.

 

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vonhelmet | 4 years ago
5 likes

The only thing we can be sure that helmets protect you from is the concerned tutting of onlookers.

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TheBillder replied to vonhelmet | 4 years ago
4 likes
vonhelmet wrote:

The only thing we can be sure that helmets protect you from is the concerned tutting of onlookers.

Aero helmets can protect quite a bit of your hair from bird poo.

Now, I know the aero helmet makes the effective size of your head bigger, thus increasing the chance of a strike. And I'm also aware that one may risk-compensate and hence be bolder on the poo front. Though I am still on the fence about whether the pigeons give you less space because the helmet is both present and aero. And above a certain speed, the poo would spread over the helmet onto my jersey - 12-15 mph I expect is the limit, and even I won't always be able to slow down to under that - ESPECIALLY WITH MY CABLE DISK BRAKES.

Furthermore, I do not wear an aero helmet because they are mostly more expensive (exception: Carnac) and would make a slow rider like me look an utter wally. But that's my personal decision and cannot be extrapolated to populations, especially as the acceptable degree of walliness cannot be determined in a double blind randomised controlled trial.

More research needed, surely.

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FluffyKittenofT... replied to vonhelmet | 4 years ago
2 likes
vonhelmet wrote:

The only thing we can be sure that helmets protect you from is the concerned tutting of onlookers.

Don't forget the nagging of family-members.
(the reviews of helmets seem to neglect that factor - never mind the physics, how well does it perform at fending off nagging and tutting?)

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Mungecrundle | 4 years ago
3 likes

I have destroyed 3 helmets in my lifetime. Each one I am convinced saved me from a trip to A&E or worse.

Each incident involved me taking a risk that I would not have taken had I not been wearing one.

I'm pretty sure they are great at saving you from minor injuries on a personal level, but at a population level and after much research I'm changing my opinion towards the negatives outweighing the positives.

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roubaixcobbles replied to Mungecrundle | 4 years ago
4 likes

Mungecrundle wrote:

I have destroyed 3 helmets in my lifetime. Each one I am convinced saved me from a trip to A&E or worse. Each incident involved me taking a risk that I would not have taken had I not been wearing one. I'm pretty sure they are great at saving you from minor injuries on a personal level, but at a population level and after much research I'm changing my opinion towards the negatives outweighing the positives.

What did this process involve? Did you think "I shouldn't do this but what they hey, I've got a helmet on so I will?"

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Mungecrundle replied to roubaixcobbles | 4 years ago
1 like
Roubaixcobbles wrote:

Mungecrundle wrote:

I have destroyed 3 helmets in my lifetime. Each one I am convinced saved me from a trip to A&E or worse. Each incident involved me taking a risk that I would not have taken had I not been wearing one. I'm pretty sure they are great at saving you from minor injuries on a personal level, but at a population level and after much research I'm changing my opinion towards the negatives outweighing the positives.

What did this process involve? Did you think "I shouldn't do this but what they hey, I've got a helmet on so I will?"

Pretty much:

1. Attempting to ride down some stone stairs, over handlebars onto edge of a stone wall, deep crease across crown of helmet.

2. Downhill in the wet, lost the front end and head hit the kerb. That was probably more a learning experience about riding in the wet to be fair rather than deliberate decision to take a risk.

3. Racing, overlapped a wheel absolutely smashed my head into the ground also injured my shoulder. I'd never close group ride or race without a helmet, it's inherently risky but the incidents are more likely in the realm that a helmet might save you some skin.

I appreciate that other people's experiences will have led them to different attitudes to what is risky. Personally I refuse to wear a helmet for my commute to work as that should not be an inherently risky activity.

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peakingintwomonths | 4 years ago
1 like

First post on helmets - eek  - and a request for information rather than an argument.  I had  a recent trip to Copenhagen, then Amsterdam.  In Copenhagen, my impression was that traffic and bikes were not particularly segregated, and a rough estimate (for personal interest) from countimg  cyclists at traffic lights, around 20% wore helmets.  In Amsterdam in the course of a day walking round, I did not see a single helmet - almost every other type of headwear from baseball cap to wooly bunnet, but no helmets. In both cities, there were the expected uncountably (to me) huge number of cyclists. Given the above (admittedly unscientific) observations one would expect that both cities would have very high absolute (not relatively) high numbers of cycling-related head injuries (huge numbers of individuals doing a 'risky' activity).  I cannot find on the internet such data (almost certainly it exisis somewhere), and also for the UK - RoSPA seem to no longer publish such data.  I am aware of the pitfalls of absolute numbers (in the UK trousers were more dangerous than guns),  but at a population level- interesting.  Anyone better placed than me able to access/produce such information ?

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Argus Tuft replied to peakingintwomonths | 4 years ago
0 likes

peakingintwomonths wrote:

First post on helmets - eek  - and a request for information rather than an argument.  I had  a recent trip to Copenhagen, then Amsterdam.  In Copenhagen, my impression was that traffic and bikes were not particularly segregated, and a rough estimate (for personal interest) from countimg  cyclists at traffic lights, around 20% wore helmets.  In Amsterdam in the course of a day walking round, I did not see a single helmet - almost every other type of headwear from baseball cap to wooly bunnet, but no helmets. In both cities, there were the expected uncountably (to me) huge number of cyclists. Given the above (admittedly unscientific) observations one would expect that both cities would have very high absolute (not relatively) high numbers of cycling-related head injuries (huge numbers of individuals doing a 'risky' activity).  I cannot find on the internet such data (almost certainly it exisis somewhere), and also for the UK - RoSPA seem to no longer publish such data.  I am aware of the pitfalls of absolute numbers (in the UK trousers were more dangerous than guns),  but at a population level- interesting.  Anyone better placed than me able to access/produce such information ?

You didn't come here to have an argument? 

Seriously ,before you start looking at the number of head injuries,take a look at the number of cycling-related hospital admissions. The effectiveness of helmets can be determined by comparing the ratio of head injuries to the above admissions pre and post helmet laws. The net public benefit of compulsory helmets (reduced activity,diabetes,obesity,etc) looks to be a negative,but that's a separate issue.

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Rich_cb replied to Argus Tuft | 4 years ago
2 likes
Argus Tuft wrote:

You didn't come here to have an argument? 

Seriously ,before you start looking at the number of head injuries,take a look at the number of cycling-related hospital admissions. The effectiveness of helmets can be determined by comparing the ratio of head injuries to the above admissions pre and post helmet laws. The net public benefit of compulsory helmets (reduced activity,diabetes,obesity,etc) looks to be a negative,but that's a separate issue.

The effectiveness cannot be measured in this way.

The reason is given later in your post.

The cycling population changes after mandatory helmet laws are introduced.

If the pre and post law populations are different then any comparison between the two groups is meaningless.

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Argus Tuft replied to Rich_cb | 4 years ago
0 likes

Rich_cb wrote:
Argus Tuft wrote:

You didn't come here to have an argument? 

Seriously ,before you start looking at the number of head injuries,take a look at the number of cycling-related hospital admissions. The effectiveness of helmets can be determined by comparing the ratio of head injuries to the above admissions pre and post helmet laws. The net public benefit of compulsory helmets (reduced activity,diabetes,obesity,etc) looks to be a negative,but that's a separate issue.

The effectiveness cannot be measured in this way. The reason is given later in your post. The cycling population changes after mandatory helmet laws are introduced. If the pre and post law populations are different then any comparison between the two groups is meaningless.

You're right-I'll just take as an indicator until someone can explain it better.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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peakingintwomonths replied to Argus Tuft | 4 years ago
1 like

Argus Tuft]</p>

<p>[quote=peakingintwomonths wrote:

before you start looking at the number of head injuries,take a look at the number of cycling-related hospital admissions. The effectiveness of helmets can be determined by comparing the ratio of head injuries to the above admissions pre and post helmet laws. 

Thanks for the reply, but I'm not sure you actually read my post properly.  Never mind, this is the helmet debate.

 

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CyclingInBeastMode replied to peakingintwomonths | 4 years ago
5 likes

peakingintwomonths wrote:

First post on helmets - eek  - and a request for information rather than an argument.  I had  a recent trip to Copenhagen, then Amsterdam.  In Copenhagen, my impression was that traffic and bikes were not particularly segregated, and a rough estimate (for personal interest) from countimg  cyclists at traffic lights, around 20% wore helmets.  In Amsterdam in the course of a day walking round, I did not see a single helmet - almost every other type of headwear from baseball cap to wooly bunnet, but no helmets. In both cities, there were the expected uncountably (to me) huge number of cyclists. Given the above (admittedly unscientific) observations one would expect that both cities would have very high absolute (not relatively) high numbers of cycling-related head injuries (huge numbers of individuals doing a 'risky' activity).  I cannot find on the internet such data (almost certainly it exisis somewhere), and also for the UK - RoSPA seem to no longer publish such data.  I am aware of the pitfalls of absolute numbers (in the UK trousers were more dangerous than guns),  but at a population level- interesting.  Anyone better placed than me able to access/produce such information ?

Interestingly Denmark like some other countries have actually been pushing helmet wearing. EU road safety report actually points the finger at DK and NL as being dangerous for cyclists based on deaths per population head and quotes low helmet wearing as to the reason why, utterly ignoring the cycling journey numbers/modal share.

EU road safety commission wants cyclists to wear helmets as part of the solution to the 'problem' of people getting killed, they'd rather offer this up as a solution than to address the actual real problem as to why people on bikes get killed/injured even in countries such as those with very low helmet wearing rates. If you look at their web pages hi-vis and helmets are plastered all over and programmes of introducing helmets are part and parcel of getting people on bikes as part of that, it's similar to bike ed here for both children and adults, helmet and hi-vis or exclusion, basically compulsion via the back door.

Of the circa 3100 SI as part of the STATS19 the estimates vary massively s to which are head injuries, also bearing in mind head injuries covers parts of the head that aren't covered by a helmet, the range covers circa 500-1200 depending on which orgs estimate you accept.

From the general population head injuries reported to hospitals is 1.3million ish with circa 160,000 hospitalisations, that data is from various sources including HEADWAY, there was a data collecting request from E&W hospitals IIRC that came to the figures. So on the basis that a large portion of serious head injuries are not going to require an overnight stay you have a massive disparity between cycling head injuries even on the lawless roads of UK (most of which are caused by criminal motorists) and those from the general population, but only one group is coerced/forced to wear.

IF and so far the IF is actually without strong evidence, helmets actually worked, the one group that requires helmets the least is people riding cycles, used elsewhere would surely save billions if they worked, so why isn't there the focus by UK gov or even the EU seeing as they beleive in the protective values of such?

Nope, it's all about diverting the focus from the real isses at hand, in Australia when they had a crackdown on driving/speeding they saw a significant reduction in cyclist KSIs, then they introduced helmet rules and stopped focussing on motorists, the rest as they say is history, increases in injury rates and lowered cycling.

The whole cycle helmet wearing thing has not just an effect on the individual but the population and the industry/activity as a whole as well as changing the way the law is enforced/upheld and discrimination towards one group only.

It's scary as how this has occured, the removal of freedoms and criminialisation of cycling with less protection by those employed to uphold law and protect us from criminals is abhorrent and in itself is unlawful.

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brooksby | 4 years ago
3 likes

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

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Argus Tuft replied to brooksby | 4 years ago
1 like

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

Like a breath of fresh air,isn't it?

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brooksby replied to Argus Tuft | 4 years ago
2 likes

Argus Tuft wrote:

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

Like a breath of fresh air,isn't it?

A definite whiff of something...  3

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Argus Tuft replied to brooksby | 4 years ago
0 likes

brooksby wrote:

Argus Tuft wrote:

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

Like a breath of fresh air,isn't it?

A definite whiff of something...  3

5000 odd posts-and you're proud of that? 

 

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brooksby replied to Argus Tuft | 4 years ago
0 likes

Argus Tuft wrote:

brooksby wrote:

Argus Tuft wrote:

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

Like a breath of fresh air,isn't it?

A definite whiff of something...  3

5000 odd posts-and you're proud of that? 

Yeah, well, I thought it was witty.

Pretty sure you've already said that you think number of posts doesn't equal importance or quality, you Young Turk - I just come here for the social life  3

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hawkinspeter replied to brooksby | 4 years ago
4 likes

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

https://en.wikipedia.org/wiki/Eternal_September

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brooksby replied to hawkinspeter | 4 years ago
1 like

hawkinspeter wrote:

brooksby wrote:

Did someone leave the gates unlocked at Arkham again...? Seems like there's a sudden influx of opinionated newbies (even being generous and presuming that they're not *intentionally* trolling).

https://en.wikipedia.org/wiki/Eternal_September

Huh. Never heard of that before, but yes I think that seems appropriate.

I must be getting old.

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Smartstu | 4 years ago
4 likes

I would suggest that before anyone supports/criticises this research - that the full research paper is read - before jumping to conclusions based on a Road.cc article (who are a bastion of accuracy of course). I want to read the whole thing to understand how wearing a helmet increases my risk of upper extremities injuries?!

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